Papers by Veerle Vanlerberghe
International Journal of Infectious Diseases
Vaccines
We performed a cross-sectional survey on vaccination-related knowledge, attitudes, and practices ... more We performed a cross-sectional survey on vaccination-related knowledge, attitudes, and practices (KAP) among randomly selected parents of <5 years-old children, elderly populations (aged ≥ 55 years), and health care workers (HCWs) in 10 health zones from 4 provinces of the Democratic Republic of Congo (DRC). Questionnaires targeted both routine (BCG, measles, polio) and outbreak-related (cholera, Ebola, COVID-19) vaccinations. In total, 2751 participants were included, 1165 parents, 1040 elderly, and 546 HCWs. In general, KAP expressed were supportive of vaccination uptake, although concerns regarding side effects and feelings of being insufficiently informed were more prevalent among parents and the elderly. Vaccine acceptance was lower for outbreak vaccinations (57%) than for routine vaccinations (90%). HCWs expressed the highest vaccine acceptance. Problems with the vaccine supply chain were reported by 20% of respondents. Despite a high level of positive KAP towards vaccinati...
SSRN Electronic Journal, 2022
Background: Few evidence exists about the degree of seroconversion and seroreversion of SARS-CoV-... more Background: Few evidence exists about the degree of seroconversion and seroreversion of SARS-CoV-2 in sub-Saharan Africa, where COVID-19 case presentation is apparently largely oligo- or asymptomatic. Methods: A cohort of 561 health care workers from 5 health zones of Kinshasa was followed up between July 2020 and January 2021, with 6-8 weeks intervals. At each visit, information on risk exposure and a blood sample was collected. Serology was defined as positive when binding antibodies against SARS-CoV-2 spike (S) and nucleocapsid proteins (NC) were simultaneously present. Association between seropositivity and exposure-related characteristics was explored in a logistic regression analysis. Cumulative incidence for sero-conversion and -reversion was computed in a sub-cohort of 316 participants with full data over the 4 surveys. Findings: The anti-SARS-CoV-2 antibodies seroprevalence was high, 17.3% (95%CI: 14.4-20.6), at baseline and fluctuating over time, being 10.4% (95%CI: 7.9-13.4), 15.8% (12.9-19.1) and 9% (6.6-12.0) in September/October, November 2020 and December 2020/January 2021 respectively. Seropositivity was heterogeneously distributed over the health zones (p<0.001), ranging from 12.5% (95%CI:6.6-20.8) in N’djili to 33.7% (95%CI:24.6-43.8) in Bandalungwa. In the sub-cohort over the 25 weeks, cumulative seroconversion was 10.7% and seroreversion was 84.1%, among participants that tested negative (n=253) and positive (n=63) at baseline, respectively. Interpretation: In Kinshasa, in contrast to the reported low number of severe COVID-19 cases in the first months after the pandemic declaration, there was a high and widespread SARS-CoV-2 IgG seroprevalence among the health care workers, characterized by a frequent and rapid seroreversion in the subsequent months.
Clinical Infectious Diseases, 2021
Background In October 2020, after the first wave of coronavirus disease 2019 (COVID-19), only 829... more Background In October 2020, after the first wave of coronavirus disease 2019 (COVID-19), only 8290 confirmed cases were reported in Kinshasa, Democratic Republic of the Congo, but the real prevalence remains unknown. To guide public health policies, we aimed to describe the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G (IgG) antibodies in the general population in Kinshasa. Methods We conducted a cross-sectional, household-based serosurvey between 22 October 2020 and 8 November 2020. Participants were interviewed at home and tested for antibodies against SARS-CoV-2 spike and nucleocapsid proteins in a Luminex-based assay. A positive serology was defined as a sample that reacted with both SARS-CoV-2 proteins (100% sensitivity, 99.7% specificity). The overall weighted, age-standardized prevalence was estimated and the infection-to-case ratio was calculated to determine the proportion of undiagnosed SARS-CoV-2 infections. Results A total of...
Background Patient-centred care is an essential component of quality of health care. We hypothesi... more Background Patient-centred care is an essential component of quality of health care. We hypothesize that integration of a mental health care package into versatile first-line health care services can strengthen patient participation, an important dimension of patient-centred care. The objective of this study is to analyse whether consultations conducted by providers in facilities that integrated mental health care score higher in terms of patient participation. Methods This study was conducted in Guinea in 12 not-for-profit health centres, 4 of which had integrated a mental health care package (MH+) and 8 had not (MH-). The study involved 450 general curative consultations (175 in MH+ and 275 in MH- centres), conducted by 18 care providers (7 in MH+ and 11 in MH- centres). Patients were interviewed after the consultation on how they perceived their involvement in the consultation, using the Patient Participation Scale (PPS). The providers completed a self-administered questionnaire ...
BMC Health Services Research, 2014
Background: Concerns about the occurrence of disease among household members generally initiate t... more Background: Concerns about the occurrence of disease among household members generally initiate treatment-seeking actions. This study aims to identify the various treatment-seeking options of patients in Lubumbashi, analyze their health-seeking behaviour, identify determinants for the use of formal care, and analyze direct health care expenditure. Methods: A cross-sectional survey of households in Lubumbashi was conducted in July 2010. Information was collected from a randomly selected sample of 251 households with at least one member who had been ill in the 2 weeks preceding the survey. Results: Frequently used initial treatment-seeking options consist of self-medication based on modern medicines (54.6%), the use of first-line health services (23.1%) and hospitals (11.9%), with a perceived effectiveness of 51%, 83% and 91% respectively. If people go for a second option, then formal health care services are most often preferred. The majority (60%) of patients' spontaneous itineraries reflect the expected functioning of a local health care system, with a patient flow characterised by the use of a first line health facility prior to the use of hospital-based services. Chronicity of the disease is the main determinant of seeking formal care. Analysis of care expenditure reveals that drugs are the only line of expenditure in the informal system and the main source of expenditure in the formal system; costs do not discriminate between first-line health services and hospitals, and the payment system is regressive since the poorest patients pay the same amounts as the richest. Conclusions: This study points to the importance of self-medication as the first therapeutic option for the majority of patients in Lubumbashi, whatever the nature of the health problem. There is a lot of room to rationalise this practice. Although formal care is not common initial therapeutic option, it is the source of care most patients turn to, especially when they believe having a chronic disease. Patients' itineraries in this urban environment are complex; health managers should try and deal with this reality. Finally, our study indicates that poor patients face the same level of out-of-pocket payments as the more wealthy ones, hence the need for more equitable health care financing arrangements.
The Lancet Global Health, 2021
Challenges in interpreting SARS-CoV-2 serological results in African countries We declare no comp... more Challenges in interpreting SARS-CoV-2 serological results in African countries We declare no competing interests. ANN and AH are joint first authors and PMK and VV are joint last authors. The study was funded by Enabel (the Belgian Development agency), GIZ (Deutsche Gesellschaft für Internationale Zusammenarbeit), and the framework agreement between the Institute of Tropical Medicine and the Belgian Development Cooperation. Additionally, AN received a doctoral scholarship from the French Institut de Recherche pour le Développement. None of the funders had a role in the design of the study, its execution, the analyses, interpretation of the data, or decision to submit the results.
The Journal of Infection in Developing Countries
Introduction: Timely and appropriate management of snakebites in the tropics is a lifesaver. Many... more Introduction: Timely and appropriate management of snakebites in the tropics is a lifesaver. Many snakebite patients are being bitten in remote rural areas and do not manage to get in due time to healthcare facilities. This study assessed the clinical features and the risk factors associated with treatment outcomes of snakebite patients admitted at two hospitals in the Northwest of Ethiopia. Methodology: In a retrospective cohort study, routinely collected data from 250 patients’ medical charts at University of Gondar Hospital and Metema Hospital, between September 2012 and August 2020, were reviewed. Results: The median age of the snakebite cases was 24 years (95% CI = 22-26), with 80.8% male patients. At admission 148/250 patients presented in Clinical stage 1 or 2 (local symptoms only) and 73.7% presented more than 12 hours after the bite, 80.2% received antibiotics and 79.0% antivenom. The median duration of hospitalization was 3 days (95% CI = 3-4); 72% of the patients recovere...
The Journal of Infection in Developing Countries
Introduction: In Sub-Saharan Africa, snakebites are a public health problem. In Ethiopia, clinica... more Introduction: In Sub-Saharan Africa, snakebites are a public health problem. In Ethiopia, clinical cases have been described, but little information exists on snakebites burden and its geographical distribution. The aim of this study was to document the spatial distribution of venomous snakes and snakebites in Ethiopia. Methodology: In a cross-sectional observational study, venomous snakes were collected during snake catching activities in six Ethiopian hotspot areas between April 2015 and September 2020. Species and habitat were described. In the hotspot areas, routine health information data on reported snakebites was collected in 78 districts and subsequently used to map annual incidence per district. Result: A total of 333 snakes were collected and 14 species were identified. The most prevalent species were Bitis arietans, Bitis arietanus somalica, Echis pyramidum, known as vipers, and Naja pallida, known as cobra. The highest number of snakes (75) was observed in the Northwest ...
Additional file 1. Adapted Patient Participation Scale (PPS) with questions submitted to the pati... more Additional file 1. Adapted Patient Participation Scale (PPS) with questions submitted to the patients.
Additional file 2. Self-assessment of care providers: list of self-administered questions.
Revue d'Épidémiologie et de Santé Publique, 2021
Qualité de la communication soignant-patient: quels apports de l'intégration de la santé mentale ... more Qualité de la communication soignant-patient: quels apports de l'intégration de la santé mentale dans des services de première ligne en Guinée ? Quality of health worker-patient communication: what are the benefits of integrating mental health into front-line services in Guinea?
Community Mental Health Journal, 2014
PLOS Neglected Tropical Diseases, 2022
Background Following earlier trials indicating that their potential in dengue vector control was ... more Background Following earlier trials indicating that their potential in dengue vector control was constrained by housing structure, a large-scale cluster-randomized trial of insecticide treated curtains (ITCs) and water jar covers (ITJCs) was undertaken in Venezuela. Methods In Trujillo, Venezuela, 60 clusters (6223 houses total) were randomized so that 15 clusters each received either PermaNet insecticide-treated window curtains (ITCs), permanent insecticide-treated water storage jar covers (ITJCs), a combination of both ITCs and ITJCs, or no insecticide treated materials (ITMs). A further 15 clusters located at least 5km from the edge of the study site were selected to act as an external control. Entomological surveys were carried out immediately before and after intervention, and then at 6-month intervals over the following 27 months. The Breteau and House indices were used as primary outcome measures and ovitrap indices as secondary. Negative binomial regression models were used ...
BMJ Global Health
BackgroundLong-lasting insecticidal nets (LLINs) are one of the key interventions in the global f... more BackgroundLong-lasting insecticidal nets (LLINs) are one of the key interventions in the global fight against malaria. Since 2014, mass distribution campaigns of LLINs aim for universal access by all citizens of Burundi. In this context, we assess the impact of LLINs mass distribution campaigns on malaria incidence, focusing on the endemic highland health districts. We also explored the possible correlation between observed trends in malaria incidence with any variations in climate conditions.MethodsMalaria cases for 2011—2019 were obtained from the National Health Information System. We developed a generalised additive model based on a time series of routinely collected data with malaria incidence as the response variable and timing of LLIN distribution as an explanatory variable to investigate the duration and magnitude of the LLIN effect on malaria incidence. We added a seasonal and continuous-time component as further explanatory variables, and health district as a random effect...
PLOS Neglected Tropical Diseases
Background Behavioural risk factors for cholera are well established in rural and semi-urban cont... more Background Behavioural risk factors for cholera are well established in rural and semi-urban contexts, but not in densely populated mega-cities in Sub-Saharan Africa. In November 2017, a cholera epidemic occurred in Kinshasa, the Democratic Republic of the Congo, where no outbreak had been recorded for nearly a decade. During this outbreak, we investigated context-specific risk factors for cholera in an urban setting among a population that is not frequently exposed to cholera. Methodology/Principal findings We recruited 390 participants from three affected health zones of Kinshasa into a 1:1 matched case control study. Cases were identified from cholera treatment centre admission records, while controls were recruited from the vicinity of the cases’ place of residence. We used standardized case report forms for the collection of socio-demographic and behavioural risk factors. We used augmented backward elimination in a conditional logistic regression model to identify risk factors....
La reemergencia/cocirculacion de enfermedades transmitidas por Aedes aegypti s e produce en medio... more La reemergencia/cocirculacion de enfermedades transmitidas por Aedes aegypti s e produce en medio de restricciones financieras. Ademas, se alude falta de efectividad o de evidencias sobre el impacto de los metodos de control. De estas razones deriva la necesidad de caracterizar rigurosamente las intervenciones para facilitar la toma de decisiones. El objetivo fue aportar evidencias cientificas basadas en la evaluacion economica de intervenciones para la prevencion de arbovirosis, que forman parte de las estrategias globales y regionales de la OMS/OPS (uso de cortinas impregnadas e insecticida residual) y tambien de estrategias locales (hospitalizacion de casos sospechosos de dengue). Se presentan tres estudios de evaluacion economica parcial apoyados en dos estudios de efectividad que fueron realizados en municipios con elevada carga epidemiologica: Guantanamo y Santiago de Cuba. Se evaluaron los costos de implementacion de cortinas impregnadas con deltametrina (CII) y el rociamient...
Emerging Infectious Diseases, 2019
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Papers by Veerle Vanlerberghe